The Main Programs Texas Runs for People With Disabilities

Texas offers several state-run programs alongside federal Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The largest is Medicaid for People With Disabilities, which covers medical care for adults and children who meet income and disability rules. Texas also runs ABLE accounts (Achieving a Better Life Experience), which let disabled people save money without losing benefits, and Home and Community-Based Services (HCBS) waivers, which pay for care in your home or community instead of in institutions.

A fourth program, Texas Workforce Commission (TWC) Vocational Rehabilitation, helps people with disabilities train for work and find jobs. Unlike benefits programs, vocational rehab is designed to move you toward employment rather than provide ongoing cash support. Each program has different rules about income, assets, disability type, and what services or support you receive.

Key Takeaways

  • Texas Medicaid covers medical care for disabled adults and children and has different income limits than federal SSI, so you may be covered by one but not the other.
  • ABLE accounts let you save up to $17,000 per year (2023 limit) without losing Medicaid or SSI, which is useful because regular savings can disqualify you from benefits.
  • HCBS waivers pay for personal care, therapy, and support services in your home or community, but waiting lists are long and vary by county and disability type.
  • Texas Workforce Commission Vocational Rehabilitation provides job training and placement support at no cost, but you must be able to work with support to be accepted.
  • You can receive multiple programs at once — for example, Medicaid plus an HCBS waiver plus SSDI — but each has its own process process and rules.

Texas Medicaid for People With Disabilities

Texas Medicaid covers hospital care, doctor visits, prescription drugs, mental health services, and long-term care for disabled adults and children. To be covered, you must meet a disability standard (usually the same one Social Security uses), but Texas has higher income limits than federal SSI. A single adult can earn up to roughly $2,313 per month in 2024 and still be covered, though the exact amount changes yearly. Asset limits are also higher than SSI — Texas allows up to $2,000 for a single person.

You explore for Texas Medicaid through Your Texas Benefits, the state's online portal, or by visiting a local Health and Human Services office. The process asks about your income, assets, household size, and disability. If you already receive SSI or SSDI, you may be automatically enrolled or have a faster review. Processing usually takes two to four weeks.

One important rule: if you work and earn income, Texas Medicaid has a "work incentive" that lets you keep more of your earnings than regular SSI rules allow. This is called the Impairment Related Work Expense (IRWE) deduction, and it can help you stay on Medicaid while earning more.

ABLE Accounts and Saving Money Without Losing Benefits

An ABLE account is a special savings account for people with disabilities. You can put money in it without losing Medicaid or SSI, up to an annual limit (currently $17,000 per year, though this may change). The account itself can hold up to $100,000 before SSI stops, and there is no limit for Medicaid. This is a major difference from regular savings: normally, having more than $2,000 in the bank disqualifies you from SSI.

To open an ABLE account in Texas, you work with a financial institution that offers them — several banks and credit unions in Texas do. You must have received a disability information from Social Security, or be a veteran with a service-connected disability rating. The account works like a regular savings account, but the money inside is protected from counting against your benefits.

ABLE accounts are useful if you want to save for a car, home repairs, education, or emergencies without triggering a benefits loss. However, if you withdraw money and spend it, it counts as income in the month you spend it, which can affect your SSI payment that month. Talk to a benefits counselor before opening one to understand how withdrawals will affect your specific situation.

Home and Community-Based Services (HCBS) Waivers

HCBS waivers pay for personal care, therapy, day programs, respite care, and other support services in your home or community. Instead of living in a nursing home or institution, you can use waiver funds to hire a home health aide, attend a day program, or get help with household tasks. Texas runs several different waivers, each designed for a specific group: children with disabilities, adults with physical disabilities, people with intellectual disabilities, and people with brain injuries.

The challenge is that waiting lists are long. Depending on the waiver and your county, you may wait months or years for services to start. To get on a waiting list, you contact the Texas Health and Human Services Commission or your local disability services office. You must meet the disability standard and income limits (usually similar to Medicaid), and a caseworker will assess what services you need.

Once you are approved and services begin, you work with a care coordinator who helps arrange and monitor your services. The waiver pays the provider directly, not you. If you move to a different county or your needs change significantly, you may have to reapply or be reassessed.

Texas Workforce Commission Vocational Rehabilitation

The Texas Workforce Commission (TWC) Vocational Rehabilitation program helps people with disabilities prepare for, find, and keep jobs. Services include career counseling, job training, education support, assistive technology, and job placement help. There is no cost to you — the program pays for training and support.

To work with TWC Vocational Rehabilitation, you must have a disability that creates a substantial barrier to employment, and you must be able to work with support. You explore at a local TWC office or through the TWC website. A counselor will meet with you to discuss your work goals, assess your skills and barriers, and create a plan. If the counselor believes you can work, you are accepted into the program.

An important rule: if you are receiving SSDI, you can work with vocational rehab and still keep your benefits during training through a program called Impairment Related Work Expenses (IRWE) or Plan to Achieve Self-Support (PASS). These let you set aside income and resources for work-related costs without losing benefits. TWC counselors understand these rules and can help you navigate them.

How These Programs Work Together

You can be in multiple programs at the same time. For example, you might receive SSDI (federal), Texas Medicaid (state), and be on an HCBS waiver waiting list all at once. Each program has its own rules and process, so you do not automatically get one when you get another.

However, programs do talk to each other in some ways. If you report a change — like a job, a move, or a new household member — you may need to report it to multiple programs. Some programs share income and asset information with each other, so lying on one process can affect another. It is better to be honest and let each program make its own decision.

If you are working or considering work, tell each program. Many have work incentives that let you earn more than you might expect. A benefits counselor can help you understand how work affects each program you are in.

How to Find Out More and get your free guide

For Texas Medicaid, visit yourtexasbenefits.hhsc.texas.gov or call 211 to find your local Health and Human Services office. For HCBS waivers, contact the Texas Health and Human Services Commission or your local disability services office — the office depends on the type of disability and waiver you are interested in.

For vocational rehabilitation, visit the Texas Workforce Commission website or go to a local TWC office. For ABLE accounts, search for "ABLE account providers in Texas" to find banks and credit unions that offer them.

If you are already receiving SSDI or SSI, you may have a benefits counselor or work incentive specialist available to you at no cost. Ask your local Social Security office or call 1-800-772-1213 to find out. These specialists understand how state programs interact with federal benefits and can help you make decisions that protect your coverage.

Frequently Asked Questions

Can I get both SSDI and Texas Medicaid at the same time?

Yes. SSDI is federal and Medicaid is state, so they are separate programs with separate rules. You can receive SSDI and still be covered by Texas Medicaid if you meet Texas's income and disability rules. In fact, many people do receive both.

What if I am on a waiting list for an HCBS waiver and need help now?

While you wait, you can use other programs: Medicaid may cover some services like therapy or medical equipment, and some nonprofits offer low-cost or free support services. Ask your local disability services office what is available in your area while you wait for the waiver.

If I start working, will I lose my Medicaid?

Not automatically. Texas Medicaid has work incentives that let you earn income and keep coverage. The amount you can earn depends on your situation, but generally you can work part-time or full-time and stay on Medicaid. Report your work to Medicaid so they can calculate your coverage correctly.

Do I have to use vocational rehab if I want to work?

No. You can work on your own and use work incentives like IRWE or PASS to protect your benefits. Vocational rehab is useful if you need help planning, training, or finding a job, but it is not required.

What happens if my income goes up while I am on Medicaid?

Texas Medicaid has higher income limits than SSI, so you may stay covered even if your income increases. Report the change to Medicaid so they can recalculate your coverage. If your income exceeds the limit, you may lose Medicaid, but you can reapply if your income drops again.